Beneath the Surface of ADHD: The ADHD Iceberg

To understand the ADHD iceberg, first picture an iceberg: a chunk of ice is visible above the water, but there’s even more below the surface, unseen.

ADHD works the same way. The ADHD iceberg model is a way to help people understand the internal and external symptoms of ADHD. Since the emphasis is often on ADHD’s external symptoms, people tend to forget that there’s more to ADHD than just what they can see. It puts this internal experience into words.

ADHD is about more than just being hyperactive or getting distracted. The ADHD iceberg captures and describes the effort people with ADHD have to put into living in a world made for neurotypical people (people without mental illness) and the psychological toll that takes on people with ADHD. 

Tip of the Iceberg of ADHD

These are the behaviors most commonly associated with ADHD. These are what people immediately think of when they think of the condition.

• Fidgeting
• Impulsive behaviors
• Concentration issues
• Getting easily distracted
• Giving up on tasks before finishing them

Under the Surface of ADHD

While the symptoms at the tip of the ADHD iceberg aren’t necessarily wrong, they tell an incomplete story. Living with ADHD can also involve dealing with challenges like:

• Sleep issues
• Executive dysfunction
• Emotional dysregulation
• Forgetting to take care of basic needs or tasks
• The monetary and time cost of memory issues
• Mood shifts
• Anger outbursts or meltdowns
• Fluctuating between being overly organized or disorganized
• Low self-esteem
• Relationship challenges
• Issues processing information
• Substance use or addictive behaviors
• Binge eating
• Constantly losing items
• Low frustration tolerance
• Comorbid conditions like depression, anxiety, eating disorders, sleep disorders, and more

How People with ADHD can use the ADHD Iceberg

The ADHD iceberg can be a helpful model for people with ADHD to explain their experiences to their colleagues, family members, partners, friends, and others.

Many people with ADHD (especially adults and girls or women) are overlooked or misunderstood because their ADHD symptoms don’t tend to look the way people expect them to. Girls and women are less likely to exhibit hyperactivity or disruptive symptoms, leading people to overlook their unique struggles. By using an easy-to-understand analogy, patients can help other people help others understand their ADHD better.

Looking at a model can also help people with ADHD understand their own experiences better. It can help them recognize behaviors and struggles as symptoms that they might not have put into words before, making it easier to explain their situation to therapists and themselves.